A gentleman in his early 40s with a background of schizophrenia on clozapine presented with a 2-month history of rectal bleeding, diarrhoea, weight loss, a microcytic anaemia and a quantitative faecal immunochemical test (qFIT) result >400 µg Hb/g. Colonoscopy demonstrated multiple large polypoid lesions in the rectum and in the sigmoid colon; the sigmoid was unable to be passed by the colonoscope due to narrowing of the lumen (figure 1). Prior to histology being reported, CT colonography was performed to further assess the colon. It reported four malignant-appearing lesions in the rectum and sigmoid with suspicious sigmoid and retroperitoneal lymph nodes (figure 2). Figure 1 Index colonoscopy demonstrating multiple erythematous polypoid lesions causing congestion and narrowing of the lumen throughout the sigmoid colon and rectum: (A) proximal sigmoid (white light endoscopy (WLE)), (B) distal sigmoid (WLE), (C) …

中文翻译：

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精神分裂症患者直肠出血的不常见原因


一名 40 岁出头的绅士，有服用氯氮平的精神分裂症背景，有 2 个月的直肠出血、腹泻、体重减轻、小细胞性贫血和粪便免疫化学定量测试 （qFIT） 结果 >400 μg Hb/g。结肠镜检查显示直肠和乙状结肠多处大息肉样病变;由于管腔变窄，结肠镜无法通过乙状结肠镜通过乙状结肠（图 1）。在报告组织学之前，进行了 CT 结肠成像以进一步评估结肠。它报告了直肠和 S 状结肠中有 4 个恶性病变，伴有可疑的 S 状结肠和腹膜后淋巴结 （图 2）。图 1 指数结肠镜检查显示多个红斑性息肉样病变导致整个乙状结肠和直肠管腔充血和狭窄：（A） 近端乙状结肠（白光内窥镜检查 （WLE）），（B） 远端乙状结肠 （WLE），（C） ...